perform surgery in a practice-based ambulatory surgery center because their
patients prefer the simplified admissions and discharge procedures and the less
New Technology. New technology and advances in anesthesia, which have been
increasingly accepted by physicians, have significantly expanded the types of
surgical procedures that are being performed in ambulatory surgery centers.
Lasers, enhanced endoscopic techniques and fiber optics have reduced the trauma
and recovery time. Improved anesthesia has shortened recovery time by minimizing
post-operative side effects such as nausea and drowsiness, thereby avoiding, in
some cases, overnight hospitalization.
AmSurg believes it is a leader in the development, acquisition and
operation of practice-based ambulatory surgery centers. The key components of
AmSurg's strategy are:
Provide Lower-Risk, High Volume Ambulatory Surgery Services. AmSurg's
surgery centers currently focus on providing lower-risk surgical procedures in
five surgical subspecialties: gastroenterology, ophthalmology, orthopaedic
surgery, urology and otolaryngology. The AmSurg single specialty practice-based
surgery center is designed, built, equipped and staffed for the needs of a
single specialty, which AmSurg believes creates efficiencies in operations.
AmSurg believes that as a result, the single specialty surgery center is a lower
cost unit to build, equip and operate, is more convenient for the physician and
patient, and therefore is potentially more attractive to managed care payors
than hospital-based or freestanding multi-specialty centers. AmSurg believes
through the combination of a network of geographically dispersed physician
groups and ambulatory surgery centers in a specific market, it can establish a
high quality, cost efficient service delivery system for a specific individual
specialty that is attractive to managed care payors.
Develop and Acquire Practice-Based Ambulatory Surgery Centers. Although
AmSurg has historically grown primarily by acquisition of existing centers, it
anticipates that its future growth in the surgery center business will come
increasingly from development of new practice-based ambulatory surgery centers.
In order to continue the acquisition and development of ambulatory surgery
centers, AmSurg will require additional capital resources in the form of debt or
equity financing. See "MANAGEMENT'S DISCUSSION AND ANALYSIS -- Liquidity and
Develop Specialty Networks. Utilizing single specialty ambulatory surgery
centers to provide a cost advantage, AmSurg's strategy has evolved to include
the development and ownership of specialty physician networks which will offer
specialty physician services, as well as outpatient surgery procedures with wide
geographic coverage to managed care payors. The specialty networks will be
developed to provide broad geographic patient access points in the market
through the network participation of high quality and strategically located
practices, some of which may be acquired or managed by AmSurg.
AmSurg has acquired two physician practices, a urology specialty group and
a gastrointestinal and primary care specialty group, in Miami, Florida, one of
which is a partner with AmSurg in a practice-based ambulatory surgery center.
The other physician practice is developing an ambulatory center with AmSurg.
AmSurg has established and is the majority owner of three start-up specialty
physician networks. By establishing these networks, AmSurg believes it will be
able to obtain additional contracts with managed care payors and increase the
profitability of its surgery centers and associated physician practices.
ACQUISITION AND DEVELOPMENT OF SURGERY CENTERS
Practice-based ambulatory surgery centers are licensed outpatient surgery
centers generally equipped and staffed for a single medical specialty and are
generally located in or adjacent to a physician group practice. AmSurg has
targeted ownership in centers that perform gastrointestinal endoscopy,
ophthalmology, urology, orthopaedics or otolaryngology procedures. These
specialties perform many high volume, lower-risk procedures that are appropriate
for the practice-based setting. The focus at each center on only the procedures
in a single specialty results in these centers generally having significantly
lower capital and operating costs than the costs of hospital and freestanding
ambulatory surgery center alternatives that are designed to provide more
intensive services in a broader array of surgical specialties. In addition, the
practice-based surgery center,